Simultaneous persistence of the urachus and vitelline ducts in an adult patient, case report

Abstract

Introduction. Umbilical pathology is a common topic in the pediatric sphere. The clinical presentation of an umbilical fistula leads to the consideration of two pathologies independently reported in literature. The first is a persistent vitelline duct and the second is a persistent urachal remnant as a result of the embryonic structures’ failure to close. They are uncommon in adults and there are no statistical data about their presentation together in the pediatric or adult population, only very few case reports. The diagnosis is mainly based on clinical suspicion. It largely depends on a physical examination noting secretion through the navel when straining or performing Valsalva maneuvers. Objective. Show an uncommon case of the simultaneous presentation of the urachus and vitelline ducts in an adult patient. Case report. Female patient aged 24 years with a background of repeated urinary tract infections and periumbilical cellulitis. A persistent vitelline duct is suspected. Therefore, the patient is subject to a surgical procedure in which the simultaneous persistence of the vitelline duct and the urachus was found incidentally. Discussion. The persistence of the vitelline duct or the persistence of the urachus individually is uncommon in adults, and the simultaneous persistence of both ducts is even rarer. The simultaneous presence of both ducts is reported mainly in infants aged under two years. Conclusions. The persistence of these ducts is rare in adults and poses a diagnostic challenge for clinicians.